Laserfiche WebLink
ONSITE WASTEWATER TREATMENT SYSTEM PERMIT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 E MAIN STREET-STOCKTON CA 95202-(209)468.3420 <br /> NON-REFUNDABLE PERMIT CALL(209)953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB ADDRESS 1 t�L��,2eu GJ2 L CIT/ZIP 10-� fA <br /> CROSS STREET APN 'L9— 02-0::0 2 /L , <br /> PARCEL SIZE T•S�� D <br /> OWNERNAME �NONE �^ <br /> -•mow•.. �H. <br /> OWNER ADDRESS RYISTATE21P <br /> CONTRACTOR CG/9�/IL /446&+5, s5a _ PHONE ZG-c1-SOZ7.•., ••-- . <br /> / t M <br /> CONTRACTOR ADDRESS _7 A�LI/Qcf !/J/fJ2. CITYISTATE ZIP <br /> LICENSE &-42 06.98 OTHER e ;NUMBER y�VY_ EXPIRATION DATE O7-3//D <br /> WATER TABLE DEPTH: ft GEOGRAPHICAL INFORMATION: Coordinates X Y <br /> ❑ PERC TEST 0 BUILDING PERMIT# O SIO)&--70 LAND USE APPLICATION# <br /> TYPE OF WORK: Pk NEW INSTALLATION I- REPAWADDITION n ENGINEER DESIGNED/ALTERNATIVE ' <br /> C REPLACEMENT 0 DESTRUCTION <br /> INSTALLATION WILL SERVE: 0 RESIDENCE tg COMMERCIAL D OTHER <br /> NUMBER OF WING UNITS: b NUMBER OF BEDROOMS: e5 NUMBER OF EMPLOYEES: <br /> I8 SEPTIC TANK TYPEIMFG CAPACITY_ gal #OFCOMPARTMENTS <br /> O GREASE TRAP TYPEIMFG CAPACITY gal #OF COMPARTMENTS <br /> DISTANCE TO NEAREST: WELL J 3b" It FOUNDATION G r ft PROPERTY LINE ft <br /> O LIFT STATION SIZE TYPE OF PUMP D PKG TX PLANT O SAND OIL SEPARATOR(ENCLOSED SYSTEM) <br /> ®. LEACH LINES LEACHING CHAMBERS .�.,4& �' `#O�F LINES LENGTH OF LINES ft ~ t <br /> DISTANCE TO NEAREST WELL J'-7b' ft FOUNDATION �b� it PROPERTY LINE fl G <br /> O FILTER BED WIDTH ft LENGTH It DEPTH it <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> O MOUNDED WIDTH It LENGTH ft DEPTH ft <br /> DISTANCE TO NEAREST WELL it FOUNDATION It PROPERTY LINE It <br /> 0 SUMPS WIDTH ft LENGTH ft DEPTH It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION ft PROPERTY LINE ft <br /> O DISPOSAL PONDS WIDTH ft LENGTH It DEPTH It <br /> DISTANCE TO NEAREST WELL ft FOUNDATION It PROPERTY LINE ft <br /> 0 SEEPAGE PITS NUMBER WIDTH ft DEPTH ft. <br /> DISTANCE TO NEAREST WELL It FOUNDATION It PROPERTY LINE ft , <br /> i <br /> I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THE WORK WILL 8E DONE IN ACCORDANCE WITH SAN JOAQUIN COUNTY ORDINANCES, i <br /> STATE LAWS AND RULES AND REGULATIONS OF SAN JOAQUIN COUNTY. <br /> MINIMUM 24 HOUR ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)933-7697 i <br /> SIGNED TITLE Milne DATE - <br /> - - <br /> ntD <br /> N1`( <br /> AL <br /> T D P Ef�T <br /> ( <br /> I <br /> I <br /> S <br /> "mow+++� - - -0EPARIMEN7U E•ON Yn_�.. __ <br /> Application Accepted B Date D X Area _ FJnpioyee ID# <br /> Final Inspection Date �. �G 11 SPECIAL PERMIT-Approved by <br /> Character of SDI/ Pth of Ft: T Pit/Sump Soil Character. <br /> COMMENTS AJe�d 3 30�[ t_ :=Qu.y.¢�fN�-� C'L�t_6"C_ wCt.t- S <br /> PE I SC Received Amount Permit/ <br /> Code INFO Cash Remitted Date Service R nest A Permit <br /> 112'r .1s9 4teo .sou.ua <br /> 42-01 ONSITE WASTEWATER TRTMNT SYSTEM PERMIT <br /> 10/4107 <br /> 1 • <br />